The term migraine headache is used to describe several different syndromes, all of which include severe, throbbing headaches on one side of the head. This pain can be so severe that it can cause widespread disturbances, affecting GI and CNS function, including mood and personality changes.
Migraine headaches should be distinguished from cluster headaches and tension headaches. Cluster headaches usually begin during sleep and involve sharp, steady eye pain that lasts 15 to 90 minutes, with sweating, flushing, tearing, and nasal congestion. Tension headaches, which usually occur at times of stress, feel like a dull band of pain around the entire head and last from 30 minutes to 1 week. They are accompanied by anorexia, fatigue, and a mild intolerance to light or sound.
There is some speculation that the female predisposition to migraine headaches may be related to the vascular sensitivity to hormones. Some women can directly plot migraine occurrence to periods of fluctuations in their menstrual cycle. The introduction of the triptan class of antimigraine drugs has been beneficial for many of these women.
Migraines generally are classified as common or classic. Common migraines, which occur without an aura, cause severe, unilateral, pulsating pain that is frequently accompanied by nausea, vomiting, and sensitivity to light and sound. Such migraine headaches are often aggravated by physical activity. Classic migraines are usually preceded by an aura—a sensation involving sensory or motor disturbances—that usually occurs about 1/2 hour before the pain begins. The pain and adverse effects are the same as those of the common migraine.
It is believed that the underlying cause of migraine headaches is arterial dilation. Headaches accompanied by an aura are associated with hypoperfusion of the brain during the aura stage, followed by reflex arterial dilation and hyperperfusion. The underlying cause and continued state of arterial dilation are not clearly understood, but they may be related to the release of bradykinins, serotonin, or a response to other hormones and chemicals.
migraine – n. 偏头痛
throbbing – a. 博动的
throbbing headaches – 博动性头痛
distinguish – v. 鉴别，识别
cluster headaches – 丛集性头痛
tension headaches -- 紧张性头痛
dull – a. 钝的
band – n. 带，索
speculation – n. 思索，推测
predisposition – n. 倾向，素因，易感性
plot – v. 划分，标绘
fluctuation – n. 波动
triptan – n. 曲坦
antimigraine – a. 抗偏头痛的
common migraines – 普通型偏头痛
aura -- n. （pl.）预兆
pulsating pain – 博动性疼痛
aggravate – v. 使恶化，使加重
classic migraines – 典型型偏头痛
precede – v. 在…之前
dilation – n. 扩张，膨胀
hypoperfusion – n. 灌注不足
hyperperfusion -- n. 灌注过度
bradykinin – n. 缓激肽
serotonin – n. 血清素
★Video★ Migraine Cluster
★Test ★
1. The nurse prepared to administer which drug to the patient with suspected opioid overdose? A. Glucose
B. Caffeine
C. Naloxone
D. Tramadol 2. The nurse monitors the patient for which therapeutic effect after the administration of an anticholinergic drug given during surgery?
A. Decreased bronchial secretions
B. Increased sensitivity to opioids
C. Decreased risk of bradycardia
D. Increased absorption of anesthetic agent
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答案 Answers 1. C. Naloxone Rationale: Naloxone is the drug of choice for treating overdose with pure opioid agonists. The drug reverses respiratory depression, coma, and other signs of opioid toxicity. Naloxone can also reverse toxicity from agonist-antagonist opioids (e.g., pentazocine, nalbuphine). However, the doses required may be higher than those needed to reverse poisoning by pure agonists. Tramadol is a moderately strong analgesic with minimal potential for dependence, abuse, or respiratory depression. The drug relieves pain through a combination of opioid and nonopioid mechanisms. 2. C. Decreased risk of bradycardia Rationale: Anticholinergic drugs may be given to decrease the risk of bradycardia during surgery. Because of the stimulation of parasympathetic reflexes, profound vagal stimulation may occur, slowing the heart rate. Anticholinergics were used in the past to prevent excessive bronchial secretions; however, because inhalation anesthetics used today are much less irritating, bronchial secretions are minimal, and anticholinergic agents are no longer needed to suppress secretions.
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